Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Semin Immunopathol. 2024 Nov 29;47(1):3. doi: 10.1007/s00281-024-01030-9.
Intrauterine adhesions (IUA), also known as Asherman's syndrome, arise from damage to the basal layer of the endometrium, frequently caused by intrauterine interventions. This damage leads to nonregenerative healing of endometrium resulting in replacement by fibrous connective tissue, which bring about the adherence of opposing endometrium to render the uterine cavity and/or cervical canal partially or completely obliterated. IUA is a common cause of the refractory uterine infertility. Hysteroscopy is the gold standard for diagnosis of IUA. However, the method of accurately predicting the likelihood of achieving a live birth in the future remains established. Classical treatments have shown limited success, particularly in severe cases. Therefore, utilizing new research methods to deepen the understanding of the pathogenesis of IUA will facilitate the new treatment approaches to be found. In this article we briefly described the advances in the pathogenesis of IUA, with focus on inflammation and parenchymal cellular homeostasis disruption, defects in autophagy and the role of ferroptosis, and we also outlined the progress in IUA therapy.
宫腔粘连（IUA），又称 Asherman 综合征，是由于子宫内膜基底层损伤引起的，常由宫腔内操作引起。这种损伤导致子宫内膜不可再生性修复，代之以纤维结缔组织，导致对向的子宫内膜粘连，使宫腔和/或宫颈管部分或完全闭塞。IUA 是难治性子宫性不孕的常见原因。宫腔镜检查是诊断 IUA 的金标准。然而，准确预测未来活产可能性的方法尚未建立。经典治疗方法的疗效有限，尤其是在严重病例中。因此，利用新的研究方法加深对 IUA 发病机制的理解，将有助于找到新的治疗方法。本文简要描述了 IUA 发病机制的研究进展，重点关注炎症和实质细胞稳态紊乱、自噬缺陷和铁死亡作用，并概述了 IUA 的治疗进展。
